The Efficacy of Systemic Lidocaine Versus Ultrasound-guided Adductor Canal Block for Patients Undergoing Total Knee Arthroplasty: a Randomized, Double-blinded, Non-inferiority Study
概览
- 阶段
- 4 期
- 干预措施
- Saline IV
- 疾病 / 适应症
- Arthroplasty, Replacement, Knee
- 发起方
- Rhode Island Hospital
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Postoperative opioid consumption
- 状态
- 已完成
- 最后更新
- 上个月
概览
简要总结
The investigators are evaluating the postoperative outcomes in patients undergoing total knee arthroplasty that receive either systemic lidocaine or ultrasound-guided adductor canal block as part of their anesthetic plan.
详细描述
Patients scheduled to have total knee arthroplasty will typically receive a single shot adductor canal block to serve as the primary anesthetic and as part of a multi-modal post-operative analgesic plan. The use of adductor canal block is still limited to where trained anesthesiologists in regional anesthesia are available. There are other nonopioid analgesic adjuncts, such as Lidocaine, which is is widely available and is a very commonly used local anesthetic. A major advantage of lidocaine is that it is not associated with a significant side effect profile. Intravenous lidocaine which can be administered during surgery and/or after surgery has demonstrated anti-inflammatory effects and can significantly decrease the reliance on opioid use for adequate pain management in abdominal and spine surgeries. The addition of systemic lidocaine infusion as part of a multimodal analgesia strategy to minimize opioid related side effects might prove to be a useful combination for clinicians where adductor canal blocks are not a viable option. However, the level of evidence comparing the efficacy of intravenous lidocaine versus adductor canal block to reduce postoperative opioid consumption in patients undergoing TKA is limited. We hypothesized that there will be no meaningful clinical difference between systemic lidocaine and ultrasound-guided adductor canal block in the 24-hour postoperative analgesia period.
研究者
入排标准
入选标准
- •ASA PS 1-3 patients undergoing primary, unilateral total knee arthroplasty
排除标准
- •ASA PS classification of 4 or greater
- •Pre-existing neuropathy
- •Coagulopathy
- •Chronic opioid consumption (\>3 months)
- •Infection at the site
- •Known allergy to study medications (lidocaine)
- •High grade atrioventricular block (cardiac conduction system impairment)
- •A history of CVA/TIA
- •Currently using lidocaine patches
- •Known liver disease
研究组 & 干预措施
Ultrasound-guided adductor canal block with local anesthetic
Single shot Ultrasound-guided adductor canal block with 0.5% ropivacaine 30 ml
干预措施: Saline IV
Ultrasound-guided adductor canal block with saline
Single shot Ultrasound-guided adductor canal block with 30 mL of normal saline (Sodium chloride)
干预措施: Lidocaine IV
结局指标
主要结局
Postoperative opioid consumption
时间窗: 24 hours
Postoperative opioid consumption will be converted to equivalent dose of oral morphine.
次要结局
- Pain Scores(up to 2 hours (post anesthesia recovery unit), 6 hours, 12 hours, and 24 hours after surgery.)
- Quality of Recovery(24 hours)